NPIMap

Organization Active NPI

Tavarua Medical Rehabilitation Services

Doing business as Tavarua Medical & Mental Services

  • Primary Care Clinic/Center
  • Van Nuys, CA
National Provider Identifier
1679832745
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
960000644 Issued in CA
Legal business name
TAVARUA MEDICAL REHABILITATION SERVICES
Doing business as
Tavarua Medical & Mental Services
Practice address
6265 Sepulveda Blvd
Suite 10
Van Nuys, CA 91411-1114
Phone
(818) 779-0555
Fax
(818) 779-0455
NPI assigned
May 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stan Sharma, PHD
Title
Executive Director
Phone
(661) 254-6630

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 960000644 CA
Primary Care Clinic/Center 261QP2300X 960000644 CA Primary

Addresses

Primary practice location

6265 Sepulveda Blvd
Suite 10
Van Nuys, CA 91411-1114

Mailing address

26460 Summit Cir
Santa Clarita, CA 91350-2991
Phone (661) 254-6630

Other names 1

  • TAVARUA MEDICAL & MENTAL SERVICES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Azusa Medical and Mental Health Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1679832745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 SUMMIT CIR",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502991",
            "telephone_number": "661-254-6630",
            "fax_number": "661-254-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6265 SEPULVEDA BLVD",
            "address_2": "SUITE 10",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111114",
            "telephone_number": "818-779-0555",
            "fax_number": "818-779-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVARUA MEDICAL REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "STAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "661-254-6630",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "960000644",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "960000644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAVARUA MEDICAL & MENTAL SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.